فصلنامه پرستاری و مامایی
پیاپی 18 (تابستان 1389)

The situations that nurses encounter in their work environment are multiple which require ethical decision-making. Therefore, during the period of their education nursing students should reach to a certain level of moral development. Regarding ethical development studies ever conducted in Iran are limited. This study aims to determine the level of nursing students’ ethical development. This descriptive correlation study was conducted in Tabriz, 2010. The study sample consisted of 115 third and fourth year nursing students of Tabriz University of Medical Sciences who were selected by census method. The instrument used in it was nursing dilemma test (NDT) questionnaire which was based on Kohlberg theory of ethical development. The questionnaire consisted of six scenarios in which the level of ethical development was determined regarding the students’ answers to the scenarios. Nursing principled thinking (NP) score, i.e. sum of fifth and sixth stages of Kohlberg ethical development, was calculated too, ranged from 18 to 66. The other indicator was practical consideration (PC) score which examines the administrative rules in ethical decision-making, ranged from 6 to 36. The data was analyzed by using SPSS statistical software and descriptive and inferential statistic analysis methods. Study data showed that 13 students (11/3%) were in second level, 8 students (7%) were in third level, 25 students (21/7%) were in 5 and 6 levels of ethical development and 14 of them (12/1%) were in PC level. This study also showed that mean NP score of student was 48/9±6/5 and mean PC score was 20/0±4/4. No significant relation was found between demographic profile and students’ ethical development. The results showed that a significant number of participated students were still at lower levels of moral development although about half of them were at NP level. These findings indicate the need for more attention to the moral education of nursing students by nursing education authorities

Primary dysmenorrhea is one of the most common disorders in young girls. This study aims to determine the severity distribution of primary dysmenorrhea according to its type and its effect on daily activities of dormitory students and treatment methods used by them. The study consisted of 108 single girl students of Tabriz University and Tabriz Medical Sciences University dormitories who were 18 to 22 years old, had dysmenorrhea without any physical or mental illnesses. Data were gathered by a questionnaires consisted of questions about demographic characteristics, medical and menstrual history, determining severity of menstrual pain (VAS using visual comparison scale. The data were analyzed by chi-square test. Almost three-quarters of the cases (70%) had experienced moderate to sever dysmenorrhea (VAS?5). More than one-third of them (38%) declared that they often/ always have been hampered by dysmenorrhea in their daily activities. Three- quarters of these girls took often/ always painkillers for relieve pain. Severity of menstrual pain in girls whose mother or sisters had had dysmenorrhea, the girls who often/ always hampered in their daily activities because of it and, also, the cases who suffered from spasmodic dysmenorrhea was significantly higher than the other ones (P<0.05). Moderate to severe dysmenorhea which prevent them from daily activities was more prevalent between students with primary dysmenorrhea which should be paid more attentions

Depo-provera and cyclofem are the only available injection methods used by 2.6% of internal groups of women of Iran.Cyclofem has been provided by the public health system since 2007. However there is no study on continuances of this method in Iran; all of the studies on DMPA published in Iran have been conducted in urban areas. The aim of this study is to compare continuation rate and reasons for discontinuation of Depo-provera and cyclofem in health houses of East Azarbaijan. A retrospective cohort study was conducted on 422 women who had started using cyclofem (202 women) or Depo-provera (220 women) within 12-24 months prior to data collection.Data were gathered by a questionnaire which was completed by interview with individuals and were analyzed by SPSS/ using Kaplan Mayer and chi-square tests. The mean age of participants was 33 year(SD=7). 10% of participants had secondary education or higher. 92.5% were housewives. Continuation rate for Cyclofem during first 24 months was significantly less than Depo-provera (P<0.001). continuation rate of the 3, 6, 9, 12 monthes use of cyclofem were 56%, 37%, 30%, 27% versus 75%, 59.5%, 48%, 42.5% for Depo-provera.The most common reasons for discontinuation in the both groups were menstural changes as a combined reason (85% for Depo-provera versus 72% for cyclofem,P=0.008) and amenorrehea as a individual reason (50% versus 22%, P<0.001). Continuation rate of cyclofem was significantly lower than Depo-provera (P<0.001). The main reason for discontinuationof the methods in both of these groups was menstrual changes especially amenorrhea or menstruation spotting which have no life-threating side effects. Regarding this case and low relativecontinuity of these methods (compared with studies conducted in other countries) health providers can help to improve continuation rate by appropriate consultation education of women.

Adolescents are strongly influenced by environmental stimuli and will do risky behaviors. Most of the health risk behaviors which are the leading cause of mortality of youth and adults is established and reinforced during adolescence ages. Life skills training (LST) is the best way to promote the psyco-social abilities in the protection unit, called “school”. One of the LST program competences is refusal skill or “saying no”. Therefore this study was performed to determine the effectiveness of school- based intervention programs on refusal skills (Say NO) for junior high schools’ students. In this study semi- experimental research a pre/post test control group design was applied and conducted on 417 students in grades 2 and 3 of Maragheh's junior high schools that were selected randomly and after the pre-test they were divided into 2 groups. In the case group LST classes of 7 sessions, and their refusal skills were measured using Dr. Botvin's healthy behavior questionnaire. Data were analyzed by SPSS /15 and t-test, ANOVA, χ2. In the case group there were significant differences between pre and post test mean scores of refusal skills. So that after performing school- based interventions refusal skills development in case group had been increased) P<0.01). Differences between post test’s and pre test’s mean and standard deviations of this group was 2.50 ± 5.58; it was _ 0.04 ±5.53 for control group (P<0.01). After intervention the refusal skill scores was significantly increased but in case group but it was decreased in control group. In the case group LST had positive effect on student's refusal skills. Then it is recommended to be used in school as a protective factor for drug abuse.

Childbirth is a stressful event for a pregnant woman who need help achieving consistency. Meanwhile delivery agents (obstetricians and midwives) play major role in it. It seems that their Preferences regarding delivery mode can influence prenatal counseling to select delivery options. The purpose of this study is to survey the personal preference of delivery agents regarding mode of delivery for themselves and their proposed mode of delivery to pregnant women; we also wish to assess the relationship between their personal preference and delivery option proposed for pregnant women. The present research is a descriptive– analytical study that was conducted during 2009. After determining validity and reliability of the tools a questionnaire consisted of some demographic social characteristics, delivery and obstetric history and a few questions about the research objectives administered to the samples.153 midwives and 90 obstetricians participated in filling out the questionnaire and data were analyzed using descriptive statistics, chi-square test and T-test for independent groups. The results of this research showed that 62.2% and obstetricians and 57.6% of midwives preferred cesarean section for themselves. 33.7% of obstetricians and 17.6% of midwives recommended this mode for first gravid women with no indication of cesarean. There was a significant statistical correlation between type of preferential delivery option for themselves and their recommended mode for pregnant women, too. The suggested mode of delivery to pregnant women was influenced by delivery agents’ preferences about their own mode of delivery.

Congenital malformations are one of the most important factors of mortality and morbidity of newborns. Infants born with congenital abnormalities impose emotional and economical problems. Abnormalities are due to chromosomal and environmental factors. The purpose of this study was to determine factors affecting risks of congenital malformations 2007 This study is a case-control study which was applied on 333 newborns with major malformation and 666 healthy newborns birth in education and treatment center of Alzahra in 2007 which were compatible in social and individual characteristics. Newborns in the control group were chosen by convenience sampling and the cases in the case group were chosen randomly. Then data were collected by interview and filling questionnaire. They were analyzed by SPSS/ver13 and independent t-test and X2. Findings of the study revealed that the most common congenital anomalies were related to the skeletal system (28/83%), the genitourinary system (28/23%), the nervous system (9/31%), the chromosomal abnormalities (8/71%), digestive system (6/61%). Results indicated that 25% of abnormal newborns’ parents had consanguineous marriage; this was 15.9% for normal babies and this difference was statically significant (P=0/004). Outcomes also represent that there were meaningful relationship between congenital malformations and diseases of mother during pregnancy, baby gender, woman’s number of pregnancies and history of abortion, prenatal care during pregnancy, mother’s taking multivitamin, ferrous sulfate and drugs during pregnancy and mode of delivery (P<0/05). There were significant differences in birth weight, gestational age and 1&5-min Apgar scores of two groups. Findings showed that the rates of consanguineous marriage, diseases of the mother during pregnancy, number of pregnancies, history of abortion, prenatal cares and mode of delivery in malformed infants were significantly higher than in normal babies. Regarding the risk of consanguineous marriage it seems necessary to educate families and young people about considering specific cases as well as getting regular prenatal cares.

The slightest neglect of nursing profession may cause loss of life in an individual due to dealing with human life. Education programs focus on clinical training and should be coordinated with development and transformation of the health care system. It is acknowledged that traditional clinical education methods are not sufficient to meet the needs of the developments and using strategies based on socio-cultural teaching methods can be more useful. This study aims to assess the present statues of nursing care in Iran because of discontentment with the current state of clinical education and poor quality and quantity of it. This descriptive study has been conducted on 38 clinical nurse instructors, working in nursing and midwifery schools of Tabriz and Urmia (the sample size is equal to the population size). Data gathering Tool was a standard questionnaire that was prepared by Bonk and Kim (1998) and then used by Phillip in 2009. After determining content and translation validity by ten masters of Tabriz University of Medical Sciences the reliability was determined by Pearson Correlation coefficient (0.90). Results showed that the majority of sociocultral based teaching strategies were moderately accepted (2.72 ± 0.44 of 4). Clinical educators gave higest priority to Scaffolding, Questioning, Educational managment, Mentoring, Direct instruction, Flexibility and the lowest priority to Explanation strategy. Socioculturally based teaching strategies are used together; instructors may use more than one clinical education strategies simultaneously. Scaffolding strategy is the as main strategy and clinical educators have accepted it more than other methods. And this is our clinical education’s strong point.